Late-preterm birth is associated with higher rates of neonatal morbidity and mortality and higher health care utilization, but its impact on later life is not well known. In this study, we aimed to evaluate whether late-preterm birth affects blood pressure, renal function, and urinary protein excretion in children later in life. Sixty-five children aged 4 to 13 years born as late-preterm and 65 age- and sex-matched children born full term were evaluated with 24-h ambulatory blood pressure monitoring (ABPM), urinary microalbumin excretion (UAE), and glomerular filtration rate (GFR). All subjects underwent ABPM prospectively. For each gender, daytime, nighttime, and 24-h systolic and diastolic and mean blood pressures (SBP, DBP, and MAP) were transformed to standard deviation scores (SDS). Blood pressure profiles (SBP DBP, and MAP) were considered abnormal when the corresponding SDS values exceeded 1.63. Urinary microalbumin excretion was expressed as milligrams per day, and the value between 30 and 300 mg/day was defined as microalbuminuria (MA). There was no significant difference in the mean GFR and MA levels between late-preterm and term children. 24-h systolic BP SDS, daytime systolic BP SDS, nighttime systolic BP SDS, 24-h diastolic BP SDS, nighttime diastolic BP SDS, 24-h MAP BP SDS, daytime MAP BP SDS, and nighttime MAP BP SDS were found to be significantly higher in late-preterm children compared to term children. Conclusion: We conclude that late-preterm children have higher BP levels, so those children should be followed up carefully by the pediatrician regarding probable hypertension in their future life.
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Fatih Gunay conceptualized and designed the study, coordinated and supervised data collection, and approved the final manuscript as submitted. İbrahim Gökce coordinated and supervised data collection, drafted the initial manuscript, reviewed and revised the manuscript, and approved the final manuscript as submitted. Harika Alpay and Hulya Bılgen carried out the initial analyses, critically reviewed and revised the manuscript, and approved the final manuscript as submitted.
Conflicts of interest
The authors have no conflicts of interest relevant to this article.
The authors have no financial relationships relevant to this article to disclose.
Bensley JG, De Matteo R, Harding R, Black MJ (2012) Preterm birth with antenatal corticosteroid administration has injurious and persistent effects on the structure and composition of the aorta and pulmonary artery. Pediatr Res 71(2):150–155PubMedCrossRefGoogle Scholar
Bensle JG, Stacy VK, De Matteo R, Harding R, Black MJ (2010) Cardiac remodelling as a result of pre-term birth: implications for future cardiovascular disease. Eur Heart J 31(16):2058–2066CrossRefGoogle Scholar
Bonay AK, Bendito A, Martin H, Andolf E, Sedin G, Norman M (2005) Preterm birth contributes to increased vascular resistance and higher blood pressure in adolescent girls. Pediatr Res 58(5):845–849CrossRefGoogle Scholar
Bonamy AK, Martin H, Jörneskog G, Norman M (2007) Lower skin capillary density, normal endothelial function and higher blood pressure in children born preterm. J Intern Med 262(6):635–642PubMedCrossRefGoogle Scholar
Cooper R, Atherton K, Power C (2009) Gestational age and risk factors for cardiovascular disease: evidence from the 1958 British birth cohort followed to mid-life. Int J Epidemiol 38(1):235–244PubMedCentralPubMedCrossRefGoogle Scholar
Doyle LW, Faber B, Callanan C, Morley R (2003) Blood pressure in late adolescence and very low birth weight. Pediatrics 111(2):252–257PubMedCrossRefGoogle Scholar
Hack M, Schluchter M, Cartar L, Rahman M (2005) Blood pressure among very low birth weight (<1.5 kg) young adults. Pediatr Res 58(4):677–684PubMedCrossRefGoogle Scholar
Hansen TW, Jeppesen J, Rasmussen S, Ibsen H, Torp-Pedersen C (2005) Ambulatory blood pressure and mortality: a population based study. Hypertension 45:499–504PubMedCrossRefGoogle Scholar
Harrison MR, Golbus MS, Filly RA, Nakayama DK, Callen PW, de Lorimier AA, Hricak H (1982) Management of the fetus with congenital hydronephrosis. J Pediatr Surg 17:728–742PubMedCrossRefGoogle Scholar
Huxley RR, Shiell AW, Law CM (2000) The role of size at birth and postnatal catch-up growth in determining systolic blood pressure: a systematic review of the literature. J Hypertens 18(7):815–831PubMedCrossRefGoogle Scholar
Johansson S, Iliadou A, Bergvall N, Tuvemo T, Norman M, Cnattingius S (2005) Risk of high blood pressure among young men increases with the degree of immaturity at birth. Circulation 112(22):3430–3436PubMedCrossRefGoogle Scholar
Keijzer-Veen MG, Finken MJ, Nauta J, Dekker FW, Hille ET, Frölich M, Wit JM, van der Heijden AJ, Dutch POPS-19 Collaborative Study Group (2005) Is blood pressure increased 19 years after intrauterine growth restriction and preterm birth? A prospective follow-up study in The Netherlands. Pediatrics 116(3):725–731PubMedCrossRefGoogle Scholar
Keijzer-Veen MG, Kleinveld HA, Lequin MH, Dekker FW, Nauta J, de Rijke YB, van der Heijden BJ (2007) Renal function and size at young adult age after intrauterine growth restriction and very premature birth. Am J Kidney Dis 50(4):542–551PubMedCrossRefGoogle Scholar
Kistner A, Celsi G, Vanpee M, Jacobson SH (2000) Increased blood pressure but normal renal function in adult women born preterm. Pediatr Nephrol 15(3–4):215–220PubMedCrossRefGoogle Scholar
Law CM, Shiell AW (1996) Is blood pressure inversely related to birth weight? The strength of evidence from a systematic review of the literature. J Hypertens 14(8):935–941PubMedCrossRefGoogle Scholar
Lawlor DA, Hübinette A, Tynelius P, Leon DA, Smith GD, Rasmussen F (2007) Associations of gestational age and intrauterine growth with systolic blood pressure in a family-based study of 386,485 men in 331,089 families. Circulation 115(5):562–568PubMedCrossRefGoogle Scholar
Lurbe E, Redon J, Alvarez V, Durazo R, Gomez A, Tacons J, Cooper RS (1996) Relationship between birth weight and awake blood pressure in children and adolescents in absence of intrauterine growth retardation. Am J Hypertens 9(8):787–794PubMedCrossRefGoogle Scholar
Raju TN, Higgins RD, Stark AR, Leveno KJ (2006) Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development. Pediatrics 118(3):1207–1214PubMedCrossRefGoogle Scholar
Siewert-Delle A, Ljungman S (1998) The impact of birth weight and gestational age on blood pressure in adult life: a population-based study of 49-year-old men. Am J Hypertens 11(8 I):946–953PubMedCrossRefGoogle Scholar
Sorof JM, Cardwell G, Franco K, Portman RJ (2002) Ambulatory blood pressure and left ventricular index in hypertensive children. Hypertension 39:903–908PubMedCrossRefGoogle Scholar
Stelloh C, Allen KP, Mattson DL, Lerch-Gaggl A, Reddy S, El-Meanawy A (2012) Prematurity in mice leads to reduction in nephron number, hypertension, and proteinuria. Transl Res 159(2):80–89PubMedCentralPubMedCrossRefGoogle Scholar
Stergiou GS, Alamara CV, Salgami EV, Vaindirlis IN, DacouVoutetakis C, Mountokalakis TD (2005) Reproducibility of home and ambulatory blood pressure in children and adolescents. Blood Press Monit 10:143–147PubMedCrossRefGoogle Scholar
Stevenson CJ, West CR, Pharoah POD (2001) Dermatoglyphic patterns, very low birth weight, and blood pressure in adolescence. Arch Dis Child 84(1):F18–F22CrossRefGoogle Scholar
Sutherland MR, Gubhaju L, Moore L, Kent AL, Dahlstrom JE, Horne RS, Hoy WE, Bertram JF, Black MJ (2011) Accelerated maturation and abnormal morphology in the preterm neonatal kidney. J Am Soc Nephrol 22(7):1365–1374PubMedCentralPubMedCrossRefGoogle Scholar
Vanpée M, Blennow M, Linné T, Herin P, Aperia A (1992) Renal function in very low birth weight infants: normal maturity reached during early childhood. J Pediatr 121:784–788PubMedCrossRefGoogle Scholar
White SL, Perkovic V, Cass A, Chang CL, Poulter NR, Spector T, Haysom L, Craig JC, Salmi IA, Chadban SJ, Huxley RR (2009) Is low birth weight an antecedent of CKD in later life? A systematic review of observational studies. Am J Kidney Dis 54(2):248–261PubMedCrossRefGoogle Scholar
Wühl E, Witte K, Soergel M, Mehls O, Schaefer F, German Working Group on Pediatric Hypertension (2002) Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 20(10):1995–2007PubMedCrossRefGoogle Scholar
Zohdi V, Sutherland MR, Lim K, Gubhaju L, Zimanyi MA, Black MJ (2012) Low birth weight due to intrauterine growth restriction and/or preterm birth: effects on nephron number and long-term renal health. Int J Nephrol 2012:136942PubMedCentralPubMedGoogle Scholar
Zureik M, Bonithon-Kopp C, Lecomte E, Siest G, Ducimetiere P (1996) Weights at birth and in early infancy, systolic pressure, and left ventricular structure in subjects aged 8 to 24 years. Hypertension 27(3 Pt 1):339–345PubMedCrossRefGoogle Scholar